Municipal regulation of communicable and vector- borne disease control in terms of South African law

Abstract

Communicable and vector-borne diseases have always been a longstanding public health threat to populations across the globe. In 2019 communicable diseases accounted for approximately 18 per cent of all global deaths. Recent disease outbreaks, such as the coronavirus and monkeypox, highlighted the fact that cities often act as epicentres for the transmission of diseases and could create health threats of international concern. South African cities are not exempt from this risk as the country faces a double burden of health challenges. These challenges include communicable diseases such as TB, HIV and AIDS, influenza and pneumonia, and chronic lower respiratory tract infections. In 2018 these diseases were among the top ten leading underlying natural causes of morbidity and mortality in South Africa. Factors that contribute to the spread of communicable and vector-borne diseases are rapid urbanisation, the mushrooming of informal urban settlements, and municipalities’ inability to deliver basic services consistently and effectively. In terms of the Constitution of the Republic of South Africa, 1996 local government is established across the whole territory of South Africa and has legal jurisdiction over all urban settlements, including cities and towns. Local government also has the duty to provide a safe and healthy environment and to provide basic municipal services. These services are necessary to ensure a reasonable quality of life and to guard against endangering public health or safety and the environment. Despite these provisions, rapid urbanisation and its subsequent developments continue to challenge municipalities' ability to provide basic services that are essential for communicable and vector-borne disease control and prevention. This study will explore the extent to which South African national and city-level law provides for the municipal regulation of communicable and vector-borne disease control.